Psychosocial reactions to a major incident

If you, a family member or friend has been involved in a major incident or event, you may experience reactions that affect your feelings and behaviour in the days and months ahead.

How you might be affected

People and communities are remarkably resilient but major events are shocking and some of them can be overwhelming. People react differently and feelings can be very powerful and difficult to live with, but they do usually become less intense with time.

People who are directly involved are the people who are most likely to be affected, but witnesses to events where people have lost their lives may also have strong feelings.

Friends and relatives not directly involved will be worried about those who appear:

stunned, dazed or numb
cut off from what is going on around them
unable to accept what has happened
feel that it hasn’t really happened

Usually, these feelings fade and others may take their place in the hours or days afterwards:

tears and sadness
fear
anxiety
feeling angry or irritable
elation about surviving
unpleasant memories or guilt about the event
problems with your concentration and/or memory
difficulties with sleeping, nightmares and tiredness
reduced appetite or energy
reluctance to discuss the event or you wish to talk about it all the time
wanting to avoid people, places or activities that remind you of the event (this might include travelling on public transport)

Possible longer term impact

The thoughts, feelings and behaviours described above are common reactions to a major incident. Sometimes these reactions last longer than several weeks and, for some, feelings may become more intense. In these circumstances, you may find it useful to contact your GP or you can seek advice through the HSC.

There are also a number of agencies that help people after bereavement or involvement in major incidents.

Support organisations and their services include:

Samaritans

offering a 24-hour helpline for those in crisis
phone: 0845 790 9090

Cruse Bereavement Care

offering counselling, advice and support throughout the UK
phone: 0844 477 9400 (Monday to Friday 9.30 am to 5.00 pm)

Disaster Action

providing support and guidance to people affected by disasters
phone: 01483 799 066

Assist Trauma Care

offering telephone counselling and support to individuals and families in the aftermath of trauma
phone: 01788 560 800 (helpline)

Occasionally, reactions may indicate you are developing a problem with mental health -such as anxiety, depression or a post traumatic stress condition. If this occurs your GP should be able to make arrangements for assessment of your needs.

The National Institute for Clinical Excellence (NICE) has produced a leaflet that gives further information on post traumatic stress disorder (PTSD) and its treatment.

Sometimes major events result in death. Grief is a normal reaction to the death of someone close to you. When that death is sudden and unexpected, normal grief reactions often become more intense, and the feelings of shock, anger and distress can feel quite overwhelming.

Many of the reactions to a major incident are similar to grief reactions, and if you have survived an event and also been bereaved by the same incident, you may find it particularly hard.

How you can help yourself

What is usually helpful

Everyone can benefit from the support of relatives and friends after a major incident. There are also things that you can do for yourself:

do things that make you feel safe and secure
try to re-establish your usual routines such as going to work or school
take good care of yourself physically; eat well, exercise regularly
take each day at a time
be patient with yourself - it may take weeks or months to feel that you, and your life,- is back to normal
allow your friends and relatives to be supportive
try to get enough sleep
talk it over when you are ready, but don't worry if you get upset or cry
take extra care - after a major incident or event, you are more likely to have an accident

What is unlikely to help

alcohol and drugs - while they can numb your feelings, they can also stop you from coming to terms with what has happened or cause more problems later
bottling up your feelings - let yourself talk when you feel ready
isolating yourself from others, although finding time to reflect on your own might be useful

Getting more help

Most people who have encountered a major incident find that they get better over time. However, if you are still having difficulties after a fortnight, you might find your GP's advice helpful.